Common Cold Lecture Notes PDF

Community Pharmacy CPP 502 Dr.Mahitab Mostafa A lecturer of Clinical Pharmacy Department  Course objectives Explain different over the counter medications for each disease Recognize adverse drug reactions, interactions an...

Community Pharmacy CPP 502 Dr.Mahitab Mostafa A lecturer of Clinical Pharmacy Department  Course objectives Explain different over the counter medications for each disease Recognize adverse drug reactions, interactions and contraindications of different pharmaceutical drug classes Apply patient counseling practices during dispensing medication Implement community pharmacist role within health care team recognize the referral trigger points in each disease choose the right dose of different medications for different populations Select the proper evidence-based treatment guidelines for each disease Dr. Mahitab Mostafa lecturer of Clinical Pharmacy Department  Outline Overview Clinical features Specific Questions Evidence- based Common Cold Management Patient counseling Trigger and Referral Points Dr. Mahitab Mostafa lecturer of Clinical Pharmacy Department How do patients develop trust in community pharmacists? LATTE Training Listen Acknowledge Take action Thank the customer Explain why the issue occurred Treat training Trust Responsive Empathy Assurance Tangibles Dr. Mahitab Mostafa lecturer of Clinical Pharmacy Department  Respiratory Tract Upper Lower Respiratory Tract respiratory tract Common cold Cough Sore Throat Allergic rhinitis Dr. Mahitab Mostafa lecturer of Clinical Pharmacy Department  Respiratory Tract The respiratory tract is divided into the upper and lower respiratory tract. Upper respiratory tract The upper respiratory tract comprises those structures located outside the thorax: the nasal cavity, pharynx and larynx. The term “common cold” refer to a mild upper respiratory tract infection Common cold is a distinct disease, and it is distinguishable from influenza, bacterial pharyngitis, allergic rhinitis, acute bronchitis, and acute bacterial sinusitis Dr. Mahitab Mostafa lecturer of Clinical Pharmacy Department  Common cold Respiratory illnesses are common in children under 5 years of age. This contagious viral infection of the upper respiratory tract is the most common infectious disease in the world and is number one reason kids visit the physician and stay home from school Children contract colds more frequently than adults, with on average five to six colds per year compared with two to four colds in adults It’s a self-limited disease caused by members of several families of viruses. Most cases are mild, but about one-third of all hospitalizations in this age group are due to respiratory problems, including asthma and pneumonia. Dr. Mahitab Mostafa lecturer of Clinical Pharmacy Department  Is it a Cold or Flu? Flu and the common cold are both respiratory illnesses, but they are caused by different viruses. Flu is worse than the common cold, and symptoms are more intense. Flu often starts abruptly with sweats and chills, muscular aches and pains in the limbs, a dry sore throat, cough and high temperature. There is often a period of generalized weakness and malaise following the worst of the symptoms. The incubation time for flu is 1–4 days and adults are contagious from the day before symptoms start until 5 days after the onset of symptoms.  Dr. Mahitab Mostafa lecturer of Clinical Pharmacy Department  Etiology More than 200 different virus types can produce symptoms of the common cold, including rhinoviruses (accounting for 30–50% of all cases), coronaviruses, parainfluenza virus, respiratory syncytial virus and adenovirus. Rhinoviruses in invisible droplets in the air we breathe or on things we touch. Manifestations of rhinovirus infection typically appear after an incubation period of 12-72 hours and last 7-11 days, but may persist for longer. Cold viruses tend to thrive in low humidity. Dr.Mahitab Mostafa lecturer of Clinical Pharmacy Department  inflammation Congestion Causes epithelial damage and irritation Fluid might drip down the back of throat, spreading the virus to the throat and upper chest ▪ Once the virus is exposed to the mucosa, it invades the nasal and bronchial epithelia, attaching to specific receptors and causing damage to the ciliated cells. ▪ The tissue injury activates cellular defense which in turn lead to the release of various inflammatory mediators e.g. prostaglandin, leukotriene and Cytokine, which leads to inflammation of the tissues lining the nose. ▪ Permeability of capillary cell walls increases, resulting in edema, which is experienced by the patient as: nasal congestion and sneezing. ▪ Viruses can cause inflammation in the nasal passageways, which creates swelling that greatly reduces or even blocks the airflow through the nostrils. In addition to inflammation, nasal congestion is also the result of dilation (enlargement) of the large blood vessels (veins) in the nose that shrink the volume of the nasal cavity and reduce airflow. ▪ These mediators induce vasodilatation and increase vascular permeability which produce nasal obstruction and nasal discharge which are symptoms of common cold virus. ▪ Histamine plays a minor role in the symptoms of common cold. ▪ Common cold is more common in winter as viruses survive more in low humidity also cold weather dries the lining of the nasal passage making it more sensitive to infection. Dr. Mahitab Mostafa lecturer of Clinical Pharmacy Department Causes of cold and their relative incidence in a community pharmacy Dr. Mahitab Mostafa lecturer of Clinical Pharmacy Department  Mode of transmission Transmission is primarily by the virus coming into contact with the hands, which then touch the nose, mouth and eyes (direct contact transmission). Respiratory droplets shed from the nose to the surfaces such as door handles and telephones. Viruses can last up to 5 hours on the sin and hard surfaces Transmission by coughing and sneezing. This is why good hygiene (washing hands frequently and using disposable tissues) remains the cornerstone of reducing the spread of a cold. Colds are most contagious during the first 1 to 2 days of symptoms. Dr. Mahitab Mostafa lecturer of Clinical Pharmacy Department Prevention Dr. Mahitab Mostafa lecturer of Clinical Pharmacy Department  Clinical features of the common cold Incubation period of between 1 and 3 days (although this can be as short as 10 to 12 hours), the patient develops: a sore throat sneezing, followed by profuse nasal discharge and congestion. Cough. Headache and malaise; mild to moderate fever (6 years Dry mouth Increased Use with caution Sedation sedation with constipation antidepressant, anxiolytics, hypnotics Systemic Phenylephrine Insomnia, Avoid Avoid in sympathomimetics >12 years Tachycardia concomitant pregnancy Pseudoephedrine use with MAOIs >6 years Avoid in Breast feeding hypertension, use with caution diabetes Topical Oxymetazoline Local Avoid Avoid in sympathomimetics >12 years irritation concomitant pregnancy Xylometazoline>6 (5%) use with MAOIs years due to risk of Breast feeding hypertensive use with caution crises Dr.Mahitab Mostafa lecturer of Clinical Pharmacy Department Doctor Referrals Dr.Mahitab Mostafa lecturer of Clinical Pharmacy Department  When to refer to physician If symptoms last for more than a week, appear at the same time every year or occur when patient is exposed to pollen, dust, animals or another substance, patient could have an allergy. A patient who has trouble breathing or wheezes when he or she catches a cold could have asthma. Also refer to physician if you think patient might have more than a cold or is getting worse instead of better. – coughing up a lot of mucus – shortness of breath – unusual lethargy/tiredness – inability to keep food or liquids down or poor fluid intake – increasing headache or facial or throat pain – severely painful sore throat that interferes with swallowing – fever of 39.3°Celsius or higher, or a fever of 38.0°Celsius or higher that lasts for more than a day – chest or stomach pain – swollen glands (lymph nodes) in the neck – earache Dr.Mahitab Mostafa lecturer of Clinical Pharmacy Department Dr.Mahitab Mostafa lecturer of Clinical Pharmacy Department